- MD Anderson Cancer Center (Houston, TX)
- …nursing experience in a hospital or clinic setting, to include experience as a case manager , triage nurse, utilization review nurse, call center nurse, or ... a hospital or clinic setting, to include experience as a case manager , triage nurse, utilization review nurse, call center nurse or related experience.… more
- CVS Health (Austin, TX)
- …license **Preferred Qualifications** * Experience with managed care, as a provider and manager of care utilization review or physician advisor experience. ... clinical issues * Provide leadership and day-to-day physician oversight for utilization management team, including the management of high-risk cases and medical… more
- Houston Methodist (Sugar Land, TX)
- At Houston Methodist, the Utilization Review Specialist Nurse (URSN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and ... this position is able to cover a multitude of utilization review functions through point of entry,...prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as… more
- Houston Methodist (Houston, TX)
- At Houston Methodist, the Utilization Review Nurse (URN) position is a licensed registered nurse (RN) who comprehensively conducts point of entry and concurrent ... prompt notification of any denials to the appropriate case manager , denials, and pre-bill team members, as well as...work experience in a hospital or insurance company providing utilization review services + Knowledge of Medicare,… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... RN experience; + Prior clinical experience, managed care experience, **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to work… more
- CenterWell (Austin, TX)
- …actual and proposed medical care and services against established CMS Coverage Guidelines/NCQA review criteria and who is interested in being part of a team that ... Prior clinical experience, managed care experience, DME, Florida Medicaid **OR** utilization management experience + Demonstrates Emotional Maturity + Ability to… more
- BAYADA Home Health Care (Austin, TX)
- …full time OASIS Review and Coding Manager . The OASIS and Coding Review Manager provides support to all BAYADA Home Health Care Medicare service offices ... + Candidates should be available Monday-Friday from 8:30am-5:00pm. _Medicare, Coder, OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health… more
- BAYADA Home Health Care (Austin, TX)
- …Home Health Care has an immediate opening for a **Full Time,** OASIS and Coding Review Manager with OASIS and Coding certification to work remotely. RN, PT, OT, ... your career with an industry leader. Apply now for immediate consideration. OASIS Review , Utilization Review , Quality Assurance, Remote, Home Health Coding,… more
- Molina Healthcare (San Antonio, TX)
- …SKILLS & ABILITIES:** + Minimum 3 years clinical nursing experience. + Minimum one year Utilization Review and/or Medical Claims Review . + Minimum two years ... DESCRIPTION** **Job Summary** Utilizing clinical knowledge and experience, responsible for review of documentation to ensure medical necessity and appropriate level… more
- HCA Healthcare (Houston, TX)
- …from any other healthcare provider. We are seeking a(an) Registered Nurse Case Manager to join our healthcare family. **Benefits** The Woman's Hospital of Texas, ... their passion for patient care. Apply today for our Registered Nurse Case Manager opportunity. **Job Summary and Qualifications** Under the direction of the Case… more